Modern medical care in the forward battlefield environment strives to provide the most advanced and timely diagnosis and treatment to casualties possible, since time factor is often crucial to the successful clinical outcomes.
One of the trauma encountered in the battlefield is cardiac ventricular fibrillation (VF) which is invariably fatal unless treated promptly. The common way to treat VF is to administer an electric pulse to the heart which shocks the heart muscle and induces it to revert to normal contraction pattern. This procedure is called defibrillation and is effected by an apparatus called ‘defibrillator’.
There are two types of defibrillators: the external and internal, the latter implanted into a patient's body. External defibrillators are relatively large and contain a large battery pack and a high voltage generator. The weight of an external defibrillator is in the order of 2-3 lbs (1-1.5 kg). The generated high voltage pulse is administered to a patient via two large conductive paddles positioned on his chest and side, respectively.
The implantable defibrillator, being very small and light is permanently surgically implanted into a patient's body, and its electrical lead is inserted into the heart. The outer case of the device is made of metal and acts as a second electrode to complete the path of electrical current through the heart. The implantable defibrillators are used in patients with chronic cardiac disease and their implantation requires a major surgery procedure in a hospital setting.
In a forward battlefield environment obtaining an external defibrillator on a short notice is problematic, since due to its size and weight it presents a carry challenge to field medical personnel who are frequently over-burdened with equipment. On the other hand, to implant a defibrillator under field conditions and within an extremely short ‘window of opportunity’ is not feasible.
Still, having a defibrillation capability ‘on-hand’ in a forward battlefield environment is very desirable in view of its potential in saving lives.